Thyroid and Hepatic Haemodynamic Alterations among Egyptian Children with Liver Cirrhosis

Background. Alterations in thyroid hormones regulation and metabolism are frequently observed in patients with cirrhosis. Aims. To assess alterations in thyroid volume (TV), haemodynamics, and hormones in patients with cirrhosis and their relation to hepatic arterial haemodynamics, and disease severity. Methods. Forty cirrhotic patients were compared to 30 healthy subjects regarding TV, free triiodiothyronine (fT(3)), free tetraiodothyronine (fT(4)), thyroid stimulating hormone (TSH), and pulsatility and resistance indices in the inferior thyroid and hepatic arteries. Results. TV (P = 0.042), thyroid volume standard deviation score (TVSDS, P = 0.001), Inferior Thyroid Artery Pulsatility Index (ITAPI, P = 0.001), Inferior Thyroid Artery Resistance Index (ITARI, P = 0.041), Hepatic Artery Pulsatility Index (HAPI, P = 0.029) and Hepatic Artery Resistance Index (HARI, P = 0.035) were higher among cases being highest in Child-C patients. FT(3) was lower in patients than controls (P = 0.001) and correlated negatively with ITAPI (r = -0.71, P = 0.021) and ITARI (r = -0.79, P = 0.011). ITAPI and ITARI correlated directly with HAPI and HARI (r = 0.62, P = 0.03, and r = 0.42, P = 0.04, resp.). Conclusions. Thyroid is involved in the haemodynamic alterations of cirrhosis. Routine study of thyroid by Doppler and assessment of thyroid functions should be performed in patients with cirrhosis to offer proper treatment if needed.